MNJ (Malang Neurology Journal)

CRANIOFACIAL ANTHROPOMETRY CHARACTERISTIC AND DERMATOGLYPHICS PATTERN AMONG SCHIZOPHRENIA SUBJECTS IN JAVANESE ETHNIC OF INDONESIA

2024-11-11T03:42:30+00:00

Background: Craniofacial dysmorphology and dermatoglyphic abnormalities in schizophrenia patients are hypothesized to reflect neurodevelopmental disturbances during embryogenesis. These markers may serve as cost-effective, non-invasive tools for identifying individuals at risk of schizophrenia.

Objective: This study aimed to explore craniofacial anthropometry and dermatoglyphic profiles as potential early markers of schizophrenia in the Javanese ethnic population.

Methods: A cross-sectional study was conducted involving 30 schizophrenia patients and 30 matched healthy controls. Craniofacial measurements (cephalic, facial, and nasal indices) were obtained, and fingerprint patterns were analyzed for dermatoglyphic traits. Statistical comparisons employed unpaired T-tests and Mann-Whitney tests.

Results: Significant differences were observed in facial index (P<0.01) and nasal index (P<0.05) between schizophrenia and control groups, with hyperleptoprosopic facial types dominating in schizophrenia patients (56.7%). Dermatoglyphic analysis showed no significant differences; however, a higher prevalence of loop patterns and reduced whorl patterns were noted in the schizophrenia group.

Conclusion: Craniofacial anthropometry demonstrates promising potential as an adjunctive marker for early schizophrenia risk detection, particularly in resource-limited settings where advanced diagnostic tools are unavailable. Although dermatoglyphic patterns revealed limited statistical significance, observed trends highlight the need for further studies. These findings provide a basis for developing population-specific screening programs and contribute to the understanding of ethnic-specific neurodevelopmental markers.

IN SILICO STUDY OF ETHYL P-METHOXYCINNAMATE (EPMS) AND GALANGIN COMPOUND AGAINTS NON-STRUCTURAL PROTEIN 3 (6W6Y) AND NON-STRUCTURAL PROTEIN 5 (6M2N) AS POTENTIAL ANTI-SARS CoV-2 DRUG

2024-02-20T05:20:08+00:00

Background: Coronavirus Disease 2019 or Covid-19 is an acute respiratory infection caused by the Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2) which causes a pandemic in various parts of the world. Studies in silico of natural compounds reveal potential drug candidate.

Objective: This research aims to predict the binding affinity of Etil P-Metoksi Sinamat (EPMS) and Galangin to Non-Structural Protein 3 (NSP3) and Non-Structural Protein 5 (NSP5) receptors using insilico approach.

Methods: This study using EPMS and Galangin against NSP3 and NSP5 of SARS CoV-2 while Remdesivir used as reference drug. Ligand interaction predicted using Molegro Virtual Docker 6.0. Physicochemical properties predicted using SwissADME. Prediction of ligand toxicity was evaluated using Protox II Online Tool and pkCSM online tool base on LD50 classification.

Results: EPMS compound had the best affinity and had the most stable binding on NSP3 (Rerank score -130.11 kcal/mol, H-Bond -10.10 kcal/mol, Moldock Score -140.56 kcal/mol) and NSP5 (Rerank score -113.87 kcal/mol, H-Bond -10.19 kcal/mol, Moldock Score -117.29 kcal/mol). Galangin compounds have lower affinity for NSP3 (Rerank score -107.02 kcal/mol, H-Bond -7.61 kcal/mol, Moldock Score -103.75 kcal/mol) and NSP5 (Rerank score -84.40 kcal/mol H-Bond -9.88 kcal/mol,Moldock Score -100.53 kcal/mol). The Docking of these two compounds were better when compared to Remdesivir in NSP3 (Rerank score -83.55 kcal/mol, H-Bond -6.88 kcal/mol, Moldock Score -99.86 kcal/mol) and NSP5 (Rerank score -83.55 kcal/mol, H-Bond -3.80 kcal/mol, Moldock Score -100.45 kcal/mol). Galangin and EPMS compounds to have better oral bioavailability than Remdesivir compounds. In the toxicity prediction test, the results showed that the EPMS compound was included in class 6 with an LD50 of 7900 mg/kg, Galangin compound was included in class 5 with an LD50 of 3919 mg/kg, Remdesivir compound was included in class 4 with an LD50 of 1190 mg/kg.

Conclusion: EPMS reveal best affinity, bioavaibility and toxicity with NSP3 and NSP5.

EFFECT OF INTRAVENOUS ADMINISTRATION OF SECRETOME ON MALONDIALDEHYDE LEVELS IN ROTENONE-INDUCED PARKINSON'S DISEASE RATS

2024-03-04T08:30:40+00:00

Background: Parkinson's disease (PD) is a progressive neurodegenerative disorder with an increasing prevalence. Oxidative stress is known to contribute to the development of PD through lipid peroxidation, which causes damage to the substantia nigra pars compacta. Lipid peroxidation produces malondialdehyde (MDA), which is known to be elevated in PD patients. Up till now, there is no cure for PD, and the available therapies are only symptomatic. The secretome from Mesenchymal Stem Cell (MSC) has antioxidant and neuroprotective components, making it a potential therapeutic agent that may slow the progression of PD.

Objective: This study seeks to determine the effect of MSC secretome on oxidative stress in rotenone-induced PD rats.

Methods: This research was an in-vivo experiment conducted with 30 male Sprague Dawley rats, divided into sham control, rotenone (+) secretome (-), and rotenone (+) secretome (+) groups. Rotenone (2.75 mg/kgBW) was administered for seven days to induce a PD model. Secretome administration (1 mg/ml) was carried out on days 3, 5, and 7. MDA levels were determined using the sandwich ELISA method.

Results: This study found no significant difference in MDA levels among the three groups (p = 0.203). The sham control group had the lowest MDA 1.32(0.53) nmol/mL, followed by the rotenone (+) secretome (+) group 1.56(0.33) nmol/ml, and the highest MDA was observed in the rotenone (+) secretome (-) group 1.88(0.14) nmol/mL.

Conclusion: Administration of MSC secretome did not significantly cause changes in plasma MDA levels of rotenone-induced Parkinson Disease rats.

EVALUATION OF BRAIN MICROGLIA PROLIFERATION AS A RESPONSE TO DBL2β-PFEMP1 RECOMBINANT PROTEIN IMMUNIZATION IN WISTAR RAT

2023-10-23T02:51:59+00:00

Background: In the malaria vaccine study, Duffy binding-like 2β Plasmodium falciparum erythrocyte membrane protein 1 (DBL2β-PfEMP1) could induce the IgG and CD4+production. Antibody to DBL2β-PfEMP1 reduces the risk of developing severe malaria through the blockade of cytoadherence and destruction of rosette formation. During the process of antibody formation after immunization, the released peripheral cytokines have the potential to cause blood-brain barrier disruption resulting in the activation and proliferation of brain microglia as primary innate immune cells leading to neuroinflammation.

Objective: This study aims to evaluate brain microglia proliferation as a response to recombinant protein DBL2β-PfEMP1 immunization in Wistar rats.

Methods: Wistar rats were injected subcutaneously with recombinant protein DBL2β-PfEMP1 at doses of 100, 150, and 200 µg/kgBW on days 0, 21, and 42. Rats were euthanized on day 56. Brain histopathological slides were prepared and stained using hematoxylin-eosin. Histological examination was performed using a microscope at 400X magnification and documented using an AmScope microscope digital camera. Brain microglia were calculated using Fiji Image-J. The data were statistically analyzed using the Kruskal-Wallis test.

Results: The average number of brain microglia in both the control and treatment groups was 82–88. There was no significant difference in brain microglia number between the control and treatment groups (p>0.05) after recombinant protein DBL2β-PfEMP1 immunization.

Conclusion: Recombinant protein DBL2β-PfEMP1 immunization does not provoke the proliferation of brain microglia in Wistar rats. This suggests that the protein does not have the potential to cause neuroinflammation.

RELATIONSHIP BETWEEN HYPOTHALAMUS AND SEXUAL ORIENTATION

2024-11-01T01:52:50+00:00

Background: Research on biological sexual differences in brain function, structure, and sexual orientation suggests links to prenatal androgen exposure, gender traits, and brain patterns, but findings remain inconclusive due to methodological challenges, inconsistent definitions, and societal or sampling biases.

Objective: Determine if there is a relationship between the size of the hypothalamus and sexual orientation.

Methods: This was a cross-sectional cohort study conducted between January 2022 and January 2023 at the Eugenio Espejo Specialties Hospital in Quito, Ecuador. Male subjects aged between 20 and 40 years participated. They were asked to reveal their sexual orientation and in the case of homosexual men, specify their sexual role as “active” or “passive”, the “versatile” did not participate in the study. The size of the hypothalamus was identified using simple MRI of the brain.

Results: A total of 51 subjects were recruited, of which 40 self-identified as homosexual, of which 25 were passive and 15 active, the remaining 11 were defined as heterosexual. It was found that there is a statistically significant relationship between the size of the hypothalamus and sexual orientation with a p = <0.001.

Conclusion: In our study, there is a statistically significant relationship between the size of the hypothalamus and sexual orientation.

Keywords: Hypothalamus, sexual orientation, MRI, heterosexual, homosexual

COMPARISON OF FLAIR AND DWI MRI IMAGES IN ACUTE CEREBRAL ISCHEMIC STROKES

2023-09-18T04:31:29+00:00

Background: Given the significance of the topic in the early identification of stroke symptoms through Magnetic Resonance Imaging (MRI) techniques.

Objective: This study aimed to compare the result of fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted imaging (DWI) MRI in the early detection of acute ischemic stroke in patients.

Methods: This cross-sectional study was done n 100 patients with stroke who referred to Alavi hospital in Ardabil city during 2019. Demographic information including age, gender, place of residence, level of education was extracted from patient’s file. Finally, MRI of these patients who were imaged through DWI and FLAIR methods was included in the checklist and then analyzed by using independent t-test and chi-2 in SPSS version 21.

Results: Among the patients studied, 70% were male, with an average age of 64.38 years. Additionally, 64% of the patients had a history of hypertension, while 39% were diagnosed with diabetes. The comparison of DWI and FLAIR results showed significant differences within the first 24 hours following the stroke event.

Conclusion: The results showed that DWI method is better than FLAIR for early detection of stroke.

THE ASSESSMENT OF SERUM ADROPIN AND CATALASE LEVELS IN PATIENTS WITH ALZHEIMER'S DISEASE

2024-07-05T08:24:58+00:00

Background: Dementia is a disease that renders performing activities of daily living difficult and has a high cost of treatment.

Objective: In this context, this study was conducted to assess the adropin and catalase levels, the relationship between adropin and catalase levels, and the roles of adropin and catalase in treatment in patients diagnosed with Alzheimer's type dementia.

Methods: This observational analytical study's sample consisted of 30 patients with Alzheimer’s disease (AD). Thirty individuals without dementia whose age and gender characteristics matched those with AD were included in the control group. The adropin and catalase levels in the serum samples collected from both patient and control groups were analyzed.

Results: Adropin and low-density lipoprotein cholesterol (LDLC) levels were notably elevated in patients with Alzheimer's disease (AD). In contrast, levels of vitamin D, albumin, and catalase were significantly reduced in these patients. Additionally, there was no meaningful correlation between the mini-mental state examination (MMSE) scores and the results of laboratory tests in individuals with AD. Additionally, it was determined that MMSE scores were positively correlated with adropin levels and negatively correlated with catalase levels. However, both correlations were statistically insignificant.

Conclusion: The low levels of catalase in patients with AD support the important role of oxidative stress in the disease. The high levels of adropin in these patients suggest that adropin acts as a defense mechanism for the body. Catalase and adropin can be used as biomarkers in the diagnosis of AD, but they are not suitable biomarkers for assessing cognitive functions.

DEPRESSION AND INTERNET GAMING DISORDER AMONG MEDICAL STUDENT IN MALANG, INDONESIA

2023-02-27T05:17:01+00:00

Background: Medical education is widely regarded as a highly demanding curriculum that causes significant stress among students. Chronis stress generates depression and increase of internet gaming activity. Previous research examined the relationship between the length of time spent for internet gaming activity as well as grade point average (GPA) towards internet gaming disorder (IGD) among medical student in Malang Indonesia. The limited data on the frequency of depression and the association between depression with IGD among medical students calls for more research.

Objectives: This study was purposed to analyse the prevalence of depression as well as its association with IGD among medical students in Malang, Indonesia.

Methods: This descriptive and cross-sectional study involved 437 medical students who completed a set of self-report questionnaires. The questionnaires included sociodemographic data, Beck Depression Inventory (BDI) scale and Personal Internet Gaming Disorder-9 (PIE-). Descriptive and bivariate analyses were employed for statistical analysis.

Results: Depression was identified among 37.99% students, with female being more likely to suffer from it. There were 59.64%, 34.94% and 5.42% correspondingly of students with mild, moderate, and severe depression. The rate of depression was highest among 1^st year students. Poor GPA achievement was observed in 50.98% of students with depression. Students without internal motivation were more likely to have depression (57.14%). Surprisingly, depression was not linked associated with IGD (p=0.06).

Conclusion: This study concluded a high prevalence of depression among medical students with various sociodemographic characteristics. Despite depression had no association with IGD, future research is necessary for evaluate the potential risk factor of depression among medical students.

THE ASSOCIATION BETWEEN STROKE DETERMINANT FACTORS AND SLEEP QUALITY IN POST-STROKE PATIENTS

2024-11-11T03:55:55+00:00

Objectives: This study was purposed to analyse the prevalence of depression as well as its association with IGD among medical students in Malang, Indonesia.

THE CORRELATION BETWEEN SLEEP QUALITY AND MEMORY FUNCTION IN MEDICAL STUDENTS

2024-02-19T03:22:54+00:00

Background: sleep is a physiological need for every human, including medical students. Studies have shown that poor sleep quality can lead to a decline in learning and memory abilities in medical students. The dual process theory explains that certain types of memory depend on common sleep conditions. This study aims to determine the association between sleep quality and short-term memory function, as measured by the digit span test, among medical students at the University of Mataram

Objective: To determine the association between sleep quality and short-term memory function as measured by the digit span test among Medical Students at the University of Mataram.

Methods: Observational analytic study with a cross-sectional design. The primary data included sociodemographic characteristics, Pittsburgh Sleep Quality Index, and the Digit Span Test. Data were analyzed using chi-square test and Fisher's exact test.

Results: 62 participants were observed. Participants ranged from 18 to 23 years, with 42 students (67.7%) identified as female. 71% of the participants experienced poor sleep quality, while 29% reported good sleep quality. All 62 students showed normal performance in the forward digit span test. In the backward digit span test, 79% obtained normal results, while 21% performed abnormally. There is no relationship between sleep quality and short-term memory (p=0,739).

Conclusion: sleep quality doesn’t influence memory function among medical students at the University of Mataram.

DIFFERENCES IN THE AMPLITUDE OF ACCOMMODATION BETWEEN CHILDREN WITHOUT DEVELOPMENTAL DISABILITIES AND CHILDREN WITH DEVELOPMENTAL DISABILITIES

2024-11-08T08:27:30+00:00

Background: Accommodation is the eye's ability to change the refractive power of the lens, allowing objects to focus on the retina at different distances. The Amplitude of Accommodation (AoA) is the closest point at which the eye can focus and the distance between the far point and near point on the diopter scale. Children with developmental disabilities (CDD) are at a higher risk of encountering vision problems, including accommodation issues.

Objective: This study aims to ascertain the disparity in Amplitude of Accommodation (AoA) results between children with developmental disabilities (CDD) and those without developmental disabilities (CWDD)

Methods: This research constitutes an observational study with cross-sectional data, involving 44 subjects with developmental disabilities (CDD) and 44 subjects without developmental disabilities (CWDD). The participants were further categorized into 33 deaf children (DC) and 11 children with intellectual disabilities (CID). The data were obtained from eye examinations conducted at several special schools and orphanages in the city of Malang. The examinations covered the right eye (OD), left eye (OS), and binocular vision (ODS).

Results: Significant differences were identified among groups in OD (P<0.001), OS (P<0.001), and ODS (P<0.001). To assess the specific variations between groups, a Bonferroni post-hoc test was conducted. The results indicated significant differences between CWDD and DC in both OD (P<0.001), OS (P<0.001), and ODS (P<0.001). Additionally, significant differences were observed between CWDD and CID in OD (P=0.002), OS (P=0.005), and ODS (P<0.001).

Conclusion: It can be concluded that there is a significant difference in the average AoA value between CWDD and CDD, both CWDD-DC and CWDD-CID.

EFFICACY OF REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION AS UPPER EXTREMITY MOTOR REHABILITATION THERAPY AFTER STROKE: A SYSTEMATIC REVIEW

2024-03-04T09:00:19+00:00

Background: The most frequent impairment following a stroke is the hemiparesis of the opposite-side upper extremity. Repetitive Transcranial Magnetic Stimulation (rTMS) is popular in research studies on upper extremity motor rehabilitation after stroke. Information regarding the onset of therapy, duration of therapy, and the type of rTMS in post-stroke upper extremity motor rehabilitation therapy is still spread in various journals, therefore researchers are interested in making this systematic review.

Objective: This study aimed to assess the efficacy of rTMS for upper extremity motor rehabilitation after stroke, and had specific aims to compare different treatment timings and durations, as well as evaluating the effectiveness of high-frequency versus low-frequency rTMS.

Methods: Literature search was conducted with multiple electronic databases, such as PubMed, ScienceDirect, Cochrane Library, and LinkSpringer. The boolean operator method will be used for the keywords and the synonyms were searched using the Medical Subject Heading (MeSH) database. Critical appraisal and Risk of biases were assessed for each study using The Joanna Briggs Institute (JBI) Critical Appraisal Tools. Data analysis in this systematic review are using descriptive analysis.

Results: The included studies consisted of two types of rTMS with varying onset and duration of the therapy. The duration of rTMS therapy consists of 5-18 sessions. In the Upper Extremity Fugl-Meyer Assessment (UE-FMA) based study, High-Frequency (HF) rTMS had significant overall results when compared to sham, whereas Low-Frequency (LF) rTMS therapy still showed contradictory results. HF-rTMS therapy can be performed in acute, subacute, and chronic stroke phases. The duration of HF-rTMS therapy can be done with 5 or 10 sessions, but it still needs further research in order to determine the number of sessions that have the best efficacy.

Conclusion: This study show HF-rTMS has better efficacy compared to LF-rTMS for upper extremity motor rehabilitation therapy after stroke.

THE CORRELATION OF SLEEP QUALITY AND SHORT-TERM MEMORY FUNCTION IN MEDICAL STUDENTS

2024-01-26T07:28:54+00:00

Background: Study on the correlation of sleep quality with short-term memory function in medical students has a high urgency considering that intelligence and good memory function are essential for their performance and learning ability in the field. There are only a few related studies on medical students in the Faculty of Medicine and Health Sciences of Universitas Udayana.

Objective: This study aims to determine the correlation between sleep quality and short-term memory function of medical students in the Faculty of Medicine and Health Sciences of Universitas Udayana.

Methods: The sample was determined by the non-probability consecutive sampling method. The Indonesian version of the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the Digit Span Backwards Task assessed sleep quality and short-term memory function respectively. The data was analyzed by Pearson correlative test and logistic regression multivariate analysis.

Results: There were 75 subjects in this study. The PSQI average score of the respondents was 9.35 ± 4.45, and the Digit Span Backwards Task average was 3.75 ± 1.77. The Pearson correlative test showed a moderate correlation between sleep quality and short-term memory function (r = -0.44.; p < 0,05). The logistic regression multivariate analysis found that sleep disturbances affect short-term memory function more than other sleep quality components, with a probability value of 98%.

Conclusion: There is a correlation between sleep quality and short-term memory function of medical students in the Faculty of Medicine and Health Sciences of Universitas Udayana.

THE ASSOCIATION OF SOCIODEMOGRAPHIC FACTORS WITH MOTOR SYMPTOMS IN PATIENTS WITH PARKINSONISM

2023-04-27T04:36:13+00:00

Background: Motor symptoms in patients with parkinsonism severely impair daily activities. Sociodemographic factors are known to play an important role in various chronic diseases, but their relationship with parkinsonism has not been studied yet.

Objective: This study aims to determine the association between sociodemographic factors and motor symptoms among patients with parkinsonism.

Methods: This cross-sectional study was conducted at Dr. Cipto Mangunkusumo National Hospital Jakarta by using the MDS Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part II questionnaire about daily motor symptoms. The target sample in this study were patients with parkinsonism based on a doctor's diagnosis, fluent in Indonesian, and had internet access.

Results: A total of 50 respondents were recruited with the most motor symptoms being difficulty dressing (90%), followed by writing, doing hobbies, tremors, and balance (88%). Bivariate analysis found that patients with low education, low income, and married had significantly worse motor symptoms (p<0.05). Multivariate analysis revealed that low education level and married status were significant risk factors, while high income level was a protective factor against poor motor symptoms.

Conclusion: Sociodemographic factors were significantly associated with motor symptoms in parkinsonism patients. This study recommends personalized patient management based on the patient's sociodemographic factors.

UNCONTROLLED DIABETES AS FACTOR AFFECTING COGNITIVE FUNCTION IN TYPE 2 DIABETES MELLITUS

2023-04-27T04:36:50+00:00

Background: Impairment or decline in cognitive function can be caused by various things, one of which is uncontrolled diabetes. In Indonesia, the research on the effect of blood sugar levels on cognitive function has been done, but still limited and less were using HbA1c.

Objective: This research aims to find correlation between HbA1C level and cognitive function based on MoCA-Ina.

Methods: This is a cross sectional study with a sample of 130 type 2 diabetes mellitus patients at Siloam Hospital Karawaci through a non-randomized purposive sampling method. Data collection was taken on January to May 2020 using medical record data for glycated hemoglobin (HbA1c) levels (cut off score 7%) and Montreal Cognitive Assessment ver. Indonesia (MoCA-Ina) score (cut off score 26) to evaluate the cognitive function. Statistical bivariate analysis performed using chi-square and multivariate analysis covariate variables using logistic regression.

Results: Uncontrolled diabetes mellitus as shown by a high HbA1c level were significantly increase the risk of cognitive decline. The study showed a significant relationship between HbA1c levels with cognitive function (OR=5,98; CI 95% 2,25-15,58; p=0,000). A logistic regression analysis of various cognitive functions showed that memory was the most affected domain in patient with uncontrolled type 2 diabetes.

Conclusion: Uncontrolled diabetes mellitus as shown by a high HbA1c level were significantly increase the risk of cognitive decline and the most affected domain was memory.

ASSOCIATION BETWEEN COGNITIVE IMPAIRMENT AND 6-12 MONTHS QUALITY OF LIFE IN ISCHEMIC STROKE

2023-04-27T04:37:25+00:00

Background: Stroke is a major contributor to deaths and disabilities worldwide. Impaired cognitive function is often found in ischemic stroke patients. Disability due to stroke causes functional impairment in various quality of life domains. Cognitive function is one of the predictors of the quality of life. There are still not many studies on cognitive impairment and quality of life in ischaemic stroke patients in Indonesia.

Objective: To compare the average quality of life of 6-12 months of stroke patients at the Bethesda Hospital Yogyakarta Neurology Center based on the presence of cognitive impairment

Methods: The study used a retrospective cohort study design. Subject data were obtained from the Bethesda Hospital Yogyakarta stroke registry. All risk factor data (laboratory and clinical) and medication were obtained during admission. Cognitive impairment was measured using the Mini Mental State Examination (MMSE) and Clock Drawing Test (CDT). The questionnaire used was World Health Organization Quality Of Life BREF (WHOQOL-BREF).

Results: From 113 patients, average quality of life of patients in domain 1, domain 2, and domain 3 was not significant (p > 0.05). A significant mean difference between cognitive impairment and quality of life was found in domain 4 (p = 0.025). Analysis of the confounding variables showed that a history of hypertension, National Institute of Health Stroke Scale (NIHSS) score, diabetes, and atrial fibrillation also had an effect on the patient's quality of life.

Conclusion: Cognitive impairment does not have a significant effect on quality of life, especially in the domains of physical health, psychological health, and social relations, but has a significant effect on the environmental health domain of ischemic stroke patients.

A RETROSPECTIVE COMPARATIVE STUDY OF THE EFFECTS AND SIDE EFFECTS OF LEVETIRACETAM AGAINST SODIUM VALPROATE IN PATIENTS DIAGNOSED WITH GENERALIZED EPILEPSY

2024-11-01T01:33:16+00:00

Background: Nearly one in every 28 people will receive a diagnosis of epilepsy at some point in their lives, but nearly half of those individuals do not receive treatment using the medications available today. It's still difficult to choose the right antiepileptic medication because it needs to be safe, effective, and bearable. For children older than one year, levetiracetam, a recently approved experimental antiepileptic, can be used as an adjuvant treatment for seizures.

Objective: The purpose of this study was to assess levetiracetam's safety and effectiveness as an adjuvant treatment for epilepsy in Iranian children and adults.

Method: Methods: Two groups of 100 patients each receiving treatment with sodium valproate and levetiracetam were included in this cross-sectional and analytical study, which involved 200 patients with generalized epilepsy who were referred to the neurology clinics of Alavi Hospital in Ardabil between 2014 and 2019. By looking through the patient files, the necessary data was gathered, such as demographics, drug side effects, degree of satisfaction with the course of therapy, and the drug's effectiveness in controlling seizures. Based on the study's goals, pertinent data was assessed by entering it into the SPSS version 17 program.

Results: Findings: There was no significant difference in the average age or gender distribution between the two groups receiving sodium valproate and levetiracetam treatment (P=0.203 and P=0.384, respectively). Headache and nausea were the most frequent adverse effects of sodium valproate and levetiracetam, respectively. While 71% of patients treated with sodium valproate had good seizure control (P<0.001), 23% and 55% of patients treated with Lobel medication had moderate and good seizure control, respectively. Additionally, 68% of the Sodium Valproate group reported good satisfaction with the treatment, compared to 50% and 24% of the Lobel receiving group (P<0.001). While 20% of patients treated with sodium valproate experienced more than three pharmacological issues, the majority of patients (82%) treated with Lobel experienced no drug difficulties at all.

Conclusion: Despite its poor performance in this area when compared to sodium valproate, the Lobel medication generally has positive effects on seizure control and patient satisfaction. On the other hand, patients treated with Lobel have experienced significantly fewer drug side effects than those treated with sodium valproate.

COMPARISON OF EFFICACY BETWEEN EDARAVONE AND RILUZOLE COMBINATION THERAPY FOR PATIENT WITH AMYOTROPHIC LATERAL SCLEROSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS

2023-09-18T04:06:12+00:00

Background: Amyotrophic Lateral Sclerosis (ALS) is a fatal neuromuscular disease with a survival period of less than 5 years. Although the past decade has shown a major growth of interest in Edaravone research due to its superior efficacy, a growing number of research done on Riluzole combinations for ALS therapy.

Objective: A systematic review is needed to compare the patient outcomes as shown in the ALS functional rating scale (ALSFRS-R) of Edaravone and Riluzole combinations.

Methods: This research is a systematic review from PubMed, ProQuest, and Science Direct. The studies included were randomized controlled trials (RCT) and post-hoc analysis of RCT published from 2012 to 2023. This research included 16 studies (11 RCT studies and 5 post-hoc studies of RCT). The studies discussed the patient population, side effects, and ALSFRS-R scores.

Results: Edaravone showed better efficacy than Riluzole combination in maintaining ALSFRS-R score with mean difference between Edaravone (MD=2.19, 95% CI: 0.42-3.96, p=0.02) and Riluzole (MD=1.67, 95% CI: -0.19-3.52, p=0.08). The meta-analysis showed heterogeneity in both Edaravone (I2=90%, p<0.00001) and Riluzole (I2=77%, p=0.004) studies.

Conclusion: The results conclusively showed that Edaravone was more efficacious than the explored Riluzole combinations so far. Nevertheless, Riluzole-Masitinib showed promising results to be further explored.

CLINICAL ASPECT OF NORMAL PRESSURE HYDROCEPHALUS: WHAT TO DO? A LITERATURE REVIEW

2023-09-26T03:48:48+00:00

Normal pressure hydrocephalus (NPH) is a medical condition characterized by the enlargement of brain ventricles and associated clinical manifestations, including gait disturbance, cognitive impairment, and urinary incontinence. In many cases, NPH is often misdiagnosed or diagnosed late due to its symptoms closely resembling those seen in other neurological conditions. Therefore, a comprehensive understanding of the clinical characteristics of NPH is crucial. This article aims to present an in-depth literature review on the clinical aspects of NPH and offer valuable insights to clinicians regarding the appropriate approach to diagnosing and managing patients with NPH. Gait apraxia is usually the first symptom, followed by incontinence and cognitive impairment, particularly in attention and memory. The diagnosis of NPH follows specific criteria, classifying patients as "possible" or "probable." Imaging examinations, such as computed tomography (CT) scans and magnetic resonance imaging (MRI), are essential to assess ventricular size and identify radiological findings such as ventriculomegaly, disproportionately enlarged subarachnoid space hydrocephalus (DESH), callosal angle, temporal cornu enlargement, and white matter changes. NPH can be managed through conservative care, ventriculoperitoneal (VP) shunt surgery, and, in select cases, endoscopic third ventriculostomy (ETV). VP shunt surgery is the main surgical option, offering different valve choices such as fixed-pressure, programmable-pressure, and overdrainage prevention mechanisms. VP shunts have been shown to effectively relieve NPH symptoms, with lumbo-peritoneal (LP) shunts considered less favorable due to higher complications. ETV is a possibility for specific patients.

BENEFICIAL EFFECTS OF ANTHOCYANINS ON NEUROCOGNITIVE FUNCTIONS: A SYSTEMATIC REVIEW

2024-07-05T08:06:22+00:00

Background: Increased research interest in natural compounds from plant has been reported to show possible protective effects on neurocognitive function. Anthocyanins, a polyphenol widely present in many red-blue fruits or plants, has received the most attention in this regard.

Objective: This study was conducted to reviews published literature of anthocyanins effect on cognitive outcomes according to PRISMA guideline.

Methods: We systematically searched relevant data in PubMed, ScienceDirect, and Medline database published in January 2014 to December 2023.

Results: Thirteen studies were reviewed consisting of animal studies (n=7) and human studies (n=6). In animal studies, the effects are particularly important for critical signaling pathways involved in the development of Parkinson's and Alzheimer’s disease. Six human studies found that consuming anthocyanins-rich foods improved either one or more cognitive outcomes with the most significant improvement across all tests associated with memory.

Conclusion: The impact of anthocyanins on cognitive aspects in both animal and human studies shows substantial potential. Due to the methodological restrictions and variations among the studies, future study is needed to explore the underlying mechanism and validate these discoveries.

UNRAVELING THE BEST NON-PHARMACOLOGICAL INTERVENTIONS FOR COGNITIVE FUNCTION AND DEPRESSION IN ELDERLY WITH COGNITIVE IMPAIRMENT: A NETWORK META-ANALYSIS

2024-11-11T03:58:00+00:00

Background: Emerging evidence suggests that non-pharmacological interventions can improve cognitive function and alleviate depressive symptoms in elderly individuals with cognitive impairment. However, the comparative effectiveness of these interventions remains unclear.

Objective: This network meta-analysis (NMA) compares the efficacy of eight non-pharmacological interventions—Virtual Reality (VR) or Exergame, Computerized Cognitive Training (CCT), Mind-Body Exercise (MBE), Physical Exercise, Music or Art Therapy, Health Education, Treatment as Usual (TAU), and a Control group (no intervention, placebo)—on cognitive function and depression in elderly individuals with cognitive impairment.

Methods: Randomized controlled trials (RCTs) published up to August 10, 2024, were systematically searched in Web of Science, PubMed, Embase, and Cochrane Library databases. A Frequentist random-effects network meta-analysis was conducted using R.

Results: Total 46 RCTs with 3043 participants were included. The pooled results showed that CCT (SMD = 2.33, 95% CI [1.34, 3.32]), Physical Exercise (SMD = 2.24, 95% CI [1.24, 3.23]), and VR or Exergame (SMD = 2.09, 95% CI [1.10, 3.08]) significantly improved global cognition. VR or Exergame was also effective in enhancing attention (SMD = -3.49, 95% CI [-6.85, -0.14]), executive function (SMD = -75.54 (95% CI [-118.24, -33.04]), and reducing depressive symptoms (SMD = -2.62, 95% CI [-4.08, -1.15]).

Conclusion: This NMA highlights the superior efficacy of CCT, Physical Exercise, and VR or Exergame in improving global cognition in elderly individuals with cognitive impairment. Additionally, VR or Exergame is particularly effective for enhancing attention, executive function, and reducing depressive symptoms, suggesting it should be integrated into cognitive rehabilitation programs.

DOSAGES ANALYSIS OF HYPERBARIC OXYGEN THERAPY TO IMPROVING COGNITIVE FUNCTION IN PATIENTS POST-TRAUMATIC BRAIN INJURY: A REVIEW

2023-03-02T04:31:14+00:00

Background: Traumatic brain injury is a type of intracranial injury caused by a mechanical impact that causes anatomical and physiological damage to the brain. Globally, there are 50 million cases of traumatic brain injury each year that cause 10 million deaths and/or hospitalizations. Hyperbaric oxygen therapy is a therapy that uses 100% oxygen at pressures greater than 1 Atmosphere Absolute (ATA) to increase tissue oxygenation and repair damaged tissue. This study was made to determine the effect of hyperbaric oxygen therapy on improving cognitive function in post-traumatic brain injury patients and the mechanisms underlying it.

Objective: To determine the dose of hyperbaric oxygen therapy that can trigger improved cognitive function in post-traumatic brain injury patients, as well as the side effects.

Methods: This research is descriptive research and uses the literature study method. In collecting data, using all journals with the search keywords "hyperbaric oxygen therapy" "traumatic brain injury" "hyperbaric oxygen therapy for TBI" "HBOT and TBI" "oxygen therapy and brain injury" published in 2017 - 2022 and indexed by Scimago Journal & Country Rank (SJR) and/or Science And Technology Index (SINTA) then new conclusions and descriptions are made.

Results: After selecting 262 journals, ten journals met the inclusion and exclusion criteria. The ten journals stated that there was an effect of hyperbaric oxygen therapy on improving cognitive function in post-traumatic brain injury patients. assessment of improvement in cognitive function in the attached journal, assessed with different parameters.

Conclusion: Hyperbaric oxygen therapy is a potential therapy to accelerate cognitive function improvement in post-traumatic brain injury patients.

APPLICATION OF NON-INVASIVE GAMMA KNIFE THERAPY IN TERM OF BRAIN TUMOR TREATMENT: A LITERATURE REVIEW

2024-07-16T13:33:02+00:00

Gamma knife radiosurgery (GKRS) is a method of stereotactic radiosurgery (SRS) therapy that used in medical therapy for benign or malignancy brain tumor patient. The aim of this article is to know efectivity of GKRS method for brain tumor therapy based on new study that focused on therapeutic advantages, type of tumor, factors that influence therapy, side effect of therapy, complication, and new study of GKRS therapy. This study is a narative literature review that be formed based on PRISMA-P guideline in 2015 through stages collecting, analysis, and citation of related journal. Colleted journal article was founded from PubMed with the topics are gamma knife, treatment, and brain tumor that include with the topics based on publication year, language, title, and abstract. Based on the results of the analysis, GKRS is SRS therapy that common used for patient with primary brain tumor or brain metastasis. GKRS therapy for patient with brain metastasis can decrease the risk of radionecrosis (RN) than whole brain radiotherapy (WBRT). The use of GKRS most often causes several symptoms after treatment such as perilesional oedema, syncope, and anxiety. New study showed there are therapy combination between SRS and WBRT such as intensity-modulated radiation therapy (IMRT) that increasead efectivity of therapy for patient with brain tumor. GKRS therapy showed that overall this therapy is effectiveness and recommended as non-invasive therapy for patient with primary brain tumor or brain metastasis.

THE ROLE OF ETHANOL CONSUMPTION IN ALTERING VISUAL OUTCOMES IN METHANOL-INDUCED TOXIC OPTIC NEUROPATHY: A CASE COMPARISON

2024-07-16T13:20:12+00:00

Methanol toxicity can cause a rapid onset of severe bilateral vision loss with prominent optic nerve head edema. This case report provides clinical manifestation of two similar acute cases of methanol induced toxic optic neuropathy with different visual outcome. The patients admitted to emergency room with weakness, headache, nausea, abdominal pain and blurred vision. Both patients drank the same bootleg alcohol 3 days before admission. The first case present worse clinical condition than the second case. Further history taking revealed the patient in second case had ingested ethanol 3 hours prior to the bootleg alcohol. Both patients were treated with hemodialysis, high dose of intravenous steroid and folic acid along with supportive therapies. Funduscopy examination and optic nerve head Ocular Coherence Tomography revealed worse edema in the first patient. On the first month follow-up, the visual acuity (VA) of the first case showed no significant improvement, while the second case revealed normal VA on both eyes. The better visual outcome in second case may caused by history of ethanol consumption which prevented more severe methanol toxicity, but further investigation may still be needed.

OPTIC NEURITIS AND SEIZURES IN A PEDIATRIC PATIENT: IS IT RELATED TO NEUROMYELITIS OPTICA SPECTRUM DISORDER?

2024-12-01T15:35:00+00:00

Background: Optic neuritis is a significant manifestation of central nervous system (CNS) demyelinating disorders, including Neuromyelitis Optica Spectrum Disorder (NMOSD). Pediatric cases are particularly challenging due to overlapping symptoms with other neurological conditions.

Objective: This case report discusses a pediatric patient presenting with bilateral optic neuritis and seizures, raising suspicion of NMOSD.

Methods: A 12-year-old male presented with acute bilateral vision loss and seizures. Comprehensive ophthalmological examinations, laboratory tests, and neuroimaging such as magnetic resonance imaging (MRI) and optical coherence tomography (OCT ) were performed. Due to financial constraints, specific NMOSD diagnostics, such as AQP4-IgG antibody testing, were not conducted. The patient was treated with high-dose intravenous methylprednisolone (IVMP) following the Optic Neuritis Treatment Trial (ONTT) protocol and valproic acid for seizure control.

Results: Significant improvement in visual acuity was observed within five days of IVMP treatment. The right eye (RE) improved from hand motions to 6/48, and the left eye (LE) from hand motions to 6/144. By day eight, further improvement in visual acuity was noted. Seizures were effectively controlled with valproic acid, and no additional neurological symptoms were reported during follow-up. MRI showed no characteristic lesions, and laboratory results were within normal limits.

Conclusion: The success of treatment despite diagnostic limitations suggests that with timely intervention, favorable outcomes are possible even in challenging settings. Future research should focus on developing accessible diagnostic tools and protocols that can be implemented in resource-limited environments. Additionally, awareness and training for healthcare providers in such settings are essential to improve early recognition and treatment of NMOSD.